Older patients with proximal femur fractures and SARS-CoV-2 infection – An observational study
Burahee et al.
, Older patients with proximal femur fractures and SARS-CoV-2 infection – An observational study
, SICOT-J, doi:10.1051/sicotj/2021001
Small retrospective study of 29 hip fracture patients in the UK, 14 with COVID-19. All COVID-19 patients were treated with vitamin D except for 2 where testing and supplementation was missed due to a clerical error. The two COVID-19 patients that died were the two that did not receive vitamin D supplementation.
risk of death, 93.3% lower, RR 0.07, p = 0.01, treatment 0 of 12 (0.0%), control 2 of 2 (100.0%), NNT 1.0, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Burahee et al., 17 Feb 2021, retrospective, United Kingdom, peer-reviewed, 4 authors, dosage 100,000IU days 1-4, additional 200000IU over four weeks if serum level insufficient.
Abstract: SICOT-J 2021, 7, 5
Ó The Authors, published by EDP Sciences, 2021
Available online at:
Older patients with proximal femur fractures and SARS-CoV-2
infection – An observational study
Abdus S Burahee1,*, Veronica E Barry1, Robert P Sutcliffe2, and Sabreena Mahroof1
Department of Orthopaedic Surgery, Royal Wolverhampton NHS Trust, WV8 1DN Wolverhampton, UK
Liver Unit, Queen Elizabeth Hospital, Birmingham B15 2WB, UK
Received 7 September 2020, Accepted 21 January 2021, Published online 17 February 2021
Abstract – Background: Older patients are at increased risk of severe COVID-19 infection and associated mortality.
There are limited data evaluating the outcome of older patients with hip fractures treated during the COVID-19
pandemic, and it has been suggested that these patients should be treated non-operatively due to high mortality risk.
The aim of this study was to report the outcomes of COVID-19 infected hip fracture patients treated at a single centre.
Methods: This was a retrospective cohort study. Data were collected from February 2020 (after the ﬁrst conﬁrmed
COVID-19 infected patient was reported in the Midlands region of the UK). All patients admitted to the hospital with
femoral neck fractures were included. Patient demographics, comorbidity, COVID-19 status, and short-term clinical
outcomes were obtained by review of electronic medical records. The outcomes of COVID-19 infected patients were
compared with non-COVID-19 patients treated during the study period. Results: Twenty-nine patients were included
(mean age of 80 years), of whom 14 (48%) were tested positive for COVID-19 infection in the postoperative period.
Overall, 26 patients (90%) underwent surgical treatment. COVID-19 infected patients had signiﬁcantly higher Charlson
comorbidity scores compared to the control group (5 vs. 4; p = 0.047). Only 5 COVID-19 infected patients (36%)
required supplemental oxygen therapy in the postoperative period, and no patients required respiratory or other organ
support. The 30-day mortality rate in COVID-19 patients was 14% compared to 0% in the negative controls (p = 0.22).
Interpretation: COVID-19 infection did not increase the mortality rate of older patients undergoing surgery for hip
fractures during the pandemic. The authors recommend careful assessment of patient ﬁtness and prompt surgical
treatment. In addition, it was noted that nearly all admissions were either given large boluses of Vitamin D or were
on maintenance supplementation, which may have affected the severity of the response to COVID-19 infections.
Key words: Proximal femur fracture, Elderly Care, COVID-19, SARS-CoV-2, Vitamin D.
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